National Provider Identifier

Philip John Derleth, D.C.

Philip John Derleth, D.C. is listed in the NPPES registry with a primary specialty of Student in an Organized Health Care Education/Training Program in Fairport, NY and a listed phone number of (585) 598-3535.

NPI 1659696771Fairport, NYStudent in an Organized Health Care Education/Training Program

Profile Overview

NPI
1659696771
Provider Type
Individual
Primary Specialty
Student in an Organized Health Care Education/Training Program
Enumeration Date
March 31, 2010
Last Updated
March 31, 2010

Practice Location

  • 1387 Fairport RD
  • Suite 640
  • Fairport, NY 14450-2003

Phone: (585) 598-3535

Mailing Address

  • 40 Valley Brook Dr
  • Fairport, NY 14450-9377

Specialties

  • Student in an Organized Health Care Education/Training Program (390200000X)
Full Record
NPI
1659696771
Entity Type
Individual
Last Name
Derleth
First Name
Philip
Middle Name
John
Name Prefix
Dr.
Credential
D.C.
Mailing Street Address
40 Valley Brook Dr
Mailing City
Fairport
Mailing State
NY
Mailing ZIP Code
14450-9377
Mailing Country
US
Mailing Phone
(585) 598-3535
Practice Street Address
1387 Fairport RD
Practice Address Line 2
Suite 640
Practice City
Fairport
Practice State
NY
Practice ZIP Code
14450-2003
Practice Country
US
Practice Phone
(585) 598-3535
Enumeration Date
March 31, 2010
Last Updated
March 31, 2010
Sex
Male
Sole Proprietor
No
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Student in an Organized Health Care Education/Training Program (390200000X)